English born CRANAplus CEO Katherine Isbister fell in love with Australia’s captivating rural and remote communities during a working holiday more than two decades ago.
Hailing from a family of nurses, Katherine trained as a nurse in the UK and primarily worked in intensive care before venturing abroad.
“As you travel around Australia, you appreciate the vastness of the country,” she says looking back.
“But for me, working in rural and remote communities, it was the health disparities that really stood out, particularly for Aboriginal and Torres Strait Islander people who lived there. It sparked an interest in wanting to work rural and remote more permanently.”
Katherine returned to the UK for a few years before making the decision to uproot and emigrate to Australia in 2003.
Initially, she worked as a nurse in Cooktown, in Far North Queensland, before undertaking training to qualify as a midwife so that she could build her skill-set in order to one day work for the Royal Flying Doctor Service (RFDS) across rural and remote Australia.
She realised the dream not long after, taking up a job as a nurse manager with the iconic organisation, which provides primary healthcare and 24-hour emergency care to Australians that live, work and travel out bush.
Katherine spent almost a decade at RFDS across a number of diverse roles.
“It was an incredibly enjoyable period for me. I started off working as a nurse manager, working in the aeromedical environment, which is very challenging but rewarding work. I then developed a passion for primary healthcare and my career took a turn in a new direction.”
In the UK, Katherine says most hospitals are only a short ambulance ride away. Whereas in Australia, getting to the nearest hospital might entail a two-hour plane ride from some areas.
During this time, Katherine became increasingly interested in the social determinants of health, undertaking a Masters of Public Health to develop her knowledge.
“I was finding that I was becoming more and more interested in prevention, the social justice side of things and addressing the inequalities and disparities in healthcare in rural and remote Australia.”
Katherine left the RFDS to work as a regional manager with UnitingCare Australia, overseeing aged care services across Far North Queensland in tackling the challenges associated with providing healthcare to an ageing population.
Primary healthcare remained a constant interest and she returned to work clinically as a primary healthcare nurse for six months.
“I think it’s important to touch base with your core nursing skills and it [working clinically] reinvigorated my passion for nursing.”
In 2019, Katherine was asked to step in as Acting CEO of CRANAplus while former CEO Christopher Cliffe was on leave. The successful stint led to her formally being appointed CEO of the organisation, the peak professional body for Australia’s remote and isolated health workforce, later that year after Mr Cliffe called it a day.
She describes the opportunity to represent such a respected and influential organisation as a privilege.
“This role is certainly the highlight of my career,” she says proudly.
“I feel that my career pathways led me to this position. I’ve been incredibly fortunate since I came to Australia, there’s been lots of opportunities that I wouldn’t necessarily have had if I’d been working in the UK. I’ve really been able to follow my passion and I’ve had incredible role models and people supporting me along the journey.”
Katherine was not formally involved with CRANAplus prior to her appointments, yet the organisation has been a source of constant inspiration from when she first arrived in Australia.
“Even when I first came to Australia, I quickly knew who CRANAplus was. When you work in rural and remote locations, often there would be a CRANAplus magazine on the coffee table or a magnet on the fridge with the telephone number for the Bush Support Line. It’s always been an organisation I felt I had an affinity with.”
The voice and influence of CRANAplus, whose mission is ‘To represent, support and educate the remote and isolated health workforce to promote the development and delivery of safe, high-quality healthcare’, has continued to grow in recent years.
As the peak body, it represents the workforce through numerous national advisory groups, steering committees and working parties, as well as by developing its own position statements.
Results of a membership survey undertaken in late 2019 found members wanted to see continued advocacy on a range of important issues including: safety and security of health workers, on call demands/fatigue management among the workforce, staff accommodation, including internet/email access, Closing the Gap and achieving equality for Aboriginal and Torres Strait Islander people, and recognition for the Remote Area Nurse (RAN).
While 2020 was designated the international Year of the Nurse and Midwife, and supposed to be an opportunity to raise the profile of the professions, the campaign was, understandably, overshadowed by the global COVID-19 pandemic.
In the early stages, CRANAplus raised concerns with the government and key stakeholders regarding the potential impact of COVID-19 in remote and isolated communities.
Some of the biggest fears concerned the limited surge capacity in remote and isolated health services to respond to a disease outbreak, inadequate stocks of Personal Protective Equipment (PPE), and response plans needing to take into account that RAN’s would likely be conducting and coordinating screening, treatment, referral and transfer of acute patients out bush.
“Lots of RAN’s were facing challenges and they were deeply concerned at the beginning of the pandemic as to what would happen in their remote communities,” Katherine says.
“I think closing down communities to visitors very quickly potentially saved lives.”
Above all, Katherine says the number one concern for RAN’s was the welfare of people living in the communities where they worked.
During the pandemic’s peak, CRANAplus’ support lines saw a 50% rise in calls.
“For us as an organisation, it was really reassuring to know that nurses were reaching out for support when they were feeling under the pump in their communities or struggling with personal issues.”
Like most organisations, CRANAplus adapted in the wake of the pandemic and widespread restrictions. For example, many of its courses and workshops shifted online, with RAN’s accessing webinars in the absence of some up-skilling opportunities.
Katherine counts steering the organisation through the pandemic as her most challenging period.
“Leading the organisation through the pandemic has probably been the most challenging thing outside of any clinical scenario that I’ve had to undertake,” she says.
“It was absolutely critical for us to continue to support the remote and isolated health workforce, but at the same time, we had to ensure that the CRANAplus staff were also safe and felt connected and supported. As an organisation, we wanted to be nimble enough to quickly adapt our products (such as courses) and services to continue to support the workforce.”
“I was fortunate enough to support the workforce at the national level, to make sure that nurses and midwives who work remotely had their voices and concerns heard. That was really rewarding for me, to have a voice at the table,” Katherine adds.
More broadly, Katherine says the global COVID-19 pandemic highlighted the courage and resilience of nurses and midwives worldwide.
“I think for me, what 2020 highlighted globally, was the real value nurses and midwives have across the world,” she says.
“What the pandemic has shown is that when health professionals come together, when nurses and midwives come together, and we all pull together collegially to work on an issue of concern, we can achieve far more than what we can do on our own.”
In September last year, CRANAplus launched its Strategic Plan for 2020-2025, outlining key priorities that will shape the direction of the organisation over coming years.
They include growing, developing and upskilling the workforce; lifting CRANAplus’ voice to advocate for remote and isolated health; improving the health and wellbeing of Aboriginal and Torres Strait Islander people who live rural and remote; and responding to health impacts from social determinants and climate change.
Whilst the organisation’s annual conference was cancelled in 2020 due to the pandemic, CRANAplus will bring its members together in a new format this year. A virtual symposium will be held in place of a national conference and smaller state-based events are being developed to help members connect and network. The 2021 theme is ‘Passion. Purpose. Influence. Impact.’
“I’d really like to see our membership continue to grow and broaden our reach,” Katherine says of her vision.
“We have the potential to work with partner organisations, and we also have an opportunity as a nursing profession to really challenge and confront racism. That is something that I feel very strongly about. We really want to ensure that cultural safety and the provision of healthcare go hand I hand, and I think we can play a role in that.”
As Australia emerges out of the peak of the pandemic in 2021, Katherine says the biggest priority will be ensuring there is a sustainable workforce. After last year, she says most nurses and midwives are feeling exhausted and need support to reset and refresh.
“The knock-on effect of the pandemic is we’re going to have a tired workforce for some time and we absolutely need to make sure that in 2021 nurses and midwives are able to take their leave and have an opportunity to refresh and recuperate,” she says.
“We also want to encourage new nurses to work remotely. I really want to raise the profile of remote area nurses and midwives. They are an amazing group of people who are highly skilled and have in-depth knowledge of primary healthcare. There’s a real opportunity in 2021 to keep promoting that and for undergraduate and newly graduated nurses and midwives to see working remote as a rewarding career pathway.’